Adenomyosis happens when the uterine lining (endometrium) grows into the muscle layer (myometrium). It’s often compared to endometriosis because both involve endometrial tissue, but they differ in location: endometriosis involves tissue outside the uterus, while adenomyosis is inside the uterine wall.
The misplaced tissue responds to hormonal cycles—thickening and breaking down each month—causing inflammation and pain because the tissue can’t exit the muscle layer.
Who Gets It
Adenomyosis can affect anyone who menstruates but is most common between ages 40–50 and in people who’ve given birth. Estimates vary, but roughly 1 in 10 people may have it.
It often coexists with other conditions, like fibroids and sometimes endometriosis.
Symptoms
Many people (about one-third) have no symptoms, but when present the most common problems are:
- Heavy, painful periods
- Irregular bleeding
- Premenstrual pelvic pain
- Pain during sex
- Painful urination or bowel movements
Heavy bleeding raises the risk of iron deficiency and anemia, which can cause fatigue and dizziness. Adenomyosis has been found in some people with fertility issues, though clear evidence that it reduces fertility is limited.
Cause
The exact cause is unknown. It’s considered hormone-dependent—symptoms usually ease after menopause—while genetics, immune factors, and prior uterine surgery (including C-section) may play roles.
The condition frequently appears alongside fibroids and, less often, endometriosis.
Diagnosis
Diagnosis can be tricky because symptoms overlap with many other conditions such as endometriosis, IBS, pelvic inflammatory disease, and perimenopause. There’s no universal diagnostic standard.
Transvaginal ultrasound detects many cases, and if results are unclear, an MRI may be used.
Treatment
There’s no single cure that targets the root cause, so treatment focuses on relieving symptoms:
- Conservative: NSAIDs for pain, iron supplements for anemia
- Hormonal: Progestin-only pills, hormonal IUDs (IUS), and combined hormonal contraceptives to reduce bleeding
- Non-surgical procedure: Uterine artery embolization (UAE) to shrink affected tissue
- Surgery: Hysterectomy as a definitive option if other treatments fail and pregnancy is not desired
Quick Summary
- Adenomyosis is endometrial tissue growing into the uterine muscle.
- Affects about 1 in 10 people, most commonly ages 40–50.
- Often confused with endometriosis; symptoms include heavy, painful periods and pelvic pain.
- Cause is unclear; diagnosis may require ultrasound or MRI.
- Treatments range from pain relief and hormonal therapy to procedures or hysterectomy in severe cases.
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